As hospitals scramble to deal with a surge in patients suffering from the novel coronavirus, some pregnant women are beginning to rethink where they want to give birth. Instead of delivering in the hospital, many are increasingly considering home births.
Joyce Kimball, a midwife in Worcester, Mass., has been helping women deliver babies at home for more than 20 years. She said she’s never gotten so many inquiries.
"Our phones are ringing off the hook,” Kimball said. “We're used to getting a request a week — and we're getting three a day."
Kimball said that's just her and her partner. As president of the Massachusetts Midwives Alliance, Kimball said there are 42 midwives in Massachusetts, and that includes six or seven she's aware of who have come out of retirement because of the surging interest in home births. All of their phones are ringing. And on the other end of the line, Kimball said, are desperate pregnant women.
“Some women are weeping in fear. Other women are incredibly scientific and have done lots of research on the studies and the safety of home birth,” Kimball said. “Other people want to know cost, because it costs money to have a home birth."
The cost is about $4,000 out of pocket. But some women and their partners feel that’s a deal, given their worries about being exposed to the novel coronavirus in the hospital and being cared for by overstretched hospital staff.
Others are concerned about obstetricians and hospitals limiting the number of pre-natal appointments to only essential things, like ultrasounds and blood work, to reduce exposure risks. Plus, hospitals are issuing new policies on how many people can be present at the delivery. Many places in Massachusetts are limiting it to just one support person.
Kimball said midwives are also changing their standard approach, given the coronavirus outbreak.
"Each home is considered potentially infectious,” Kimball said. “Aprons and changes of clothing and masks and everything gets wipe down with [antiseptic] wipes."
In the past, midwives never used masks, she said. Now, they are largely using homemade cloth masks due to the shortage of disposable medical ones.
In the pre-coronavirus world, just above 1 percent of women in the U.S. gave birth at home. Kimball thinks that percentage will be going up this year.
“It's not like anything changed on the homebirth part. It's just that the awareness has been raised. This coronavirus just simply brought the benefits of homebirth to light," Kimball said.
But many doctors don't think this emerging trend is a good thing.
"Hospitals and accredited birthing centers are still considered to be the safest setting for birth," said Tiffany Moore Simas, the vice chair of obstetrics and gynecology at the UMass Medical Center in Worcester. “Of course, each woman has the right to make a medically informed decision. However, if she was not considering a home birth before the pandemic, I would say now is not the time to consider that."
Moore Simas said labor and delivery wards are working really hard to ensure they are protected from the outbreak. And she’s not sure pregnant women are hearing this as clearly as they could be.
“They're hearing a lot in the media about not enough hospital beds or decreased hospital capacity. I think the media does not do a good job of making a distinction between ICU beds and things of that nature, and maternity centers,” she said.
Moore Simas said hospitals are creating careful protocol to help safeguard pregnant women and their families.
“We are very, very careful about [hospital staff] not going in between rooms and, in some hospitals, there are now teams that are dedicated to caring for [pregnant] patients with COVID that are separate from the teams that are caring for other women,” she said.
Moore Simas also pointed out that many births go smoothly, but that when things go wrong, they can go wrong quickly. And that’s when the pregnant woman should to be at a hospital that has all the tools and expertise to intervene.
Plus, she said, by inviting a midwife into your home, you are inviting in someone who has seen a lot of other people despite this time of social distancing.
Both midwife and physician agree that whether women deliver in the hospital or at home, neither setting can totally guarantee that mom and baby are not exposed to the novel coronavirus.